| NPI | 1689118093 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC GLENN HALVORSON President 919-259-9128 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: NC NCAP00001004) |
| Additional Taxonomies | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: NC BP5921526) |
| Enumeration Date | 2016-12-05 |
| Last Update Date | 2023-05-30 |